Changes in the emotional and volitional sphere in alcoholics

Alcoholism (as well as drug addiction) is a disease that destroys all areas of the patient’s life, namely the mental, biological and social aspects of human activity. In addition, it is no secret that this disease has a detrimental effect on both the life of the alcoholic himself and his family members.

Alcoholic psychosis is a consequence of alcoholism as a disease that is characterized by a chronic and progressive course. It is not surprising that one or another type of psychosis appeared after 5-7 years of alcohol abuse (if psychosis appeared much earlier, then this is already a symptom of drug addiction), that is, approximately the third stage of alcoholism. Thus, alcoholic psychosis is as natural for an alcoholic as a cough is for a smoker, and is not just a complication after long-term drunkenness, but also a significant symptom of alcoholism as a disease.

As a rule, psychosis manifests itself in a patient during the early stages of abstinence, that is, when, for one reason or another, a person refuses alcohol.

In addition, the occurrence of one or another type of alcoholic psychosis may be accompanied by other factors, including traumatic brain injury, a previous infectious disease, a severe stressful situation and some other mechanisms that catalyze the development of alcoholic psychosis.

Most psychoses have certain general forms and stages of development. Doctors distinguish three forms of alcoholic psychosis:

• acute alcoholic psychosis,
• subacute alcoholic psychosis,
• chronic psychosis.

Each of these forms has certain specific development and treatment features. Approximately 70% of alcoholic psychoses are acute. Naturally, after a patient has suffered one or another type of psychosis, the likelihood of relapse, that is, repeated manifestation of the disease, is higher than for those alcoholics in whom alcoholic psychosis has not yet manifested itself. Unfortunately, in many cases, a series of psychoses often becomes the norm for an alcoholic. This happens, first of all, when the patient does not receive the necessary professional medical care.

Now let's turn to the main types of alcoholic psychoses that are most often encountered in medical practice.

What is alcoholic psychosis

Alcoholic psychosis is a disorder associated with delusional thoughts and hallucinations due to excessive drinking. Due to prolonged drinking bouts, perception deception is formed: visual, auditory, tactile hallucinations. Temporal and spatial disorientation is added. The alcohol addict does not understand where he is or even what season of the year it is. Delusional thoughts vary (fear of persecution is a very common idea). The depressing state is intensified by hallucinations.

Alcohol psychosis

In alcopsychosis, a person completely loses the ability to think critically. Without medical care, the death rate increases. Some alcohol-dependent citizens may die even after falling into the hands of medical personnel. Especially with late admission. The dose and duration of drinking that influences the onset of psychosis is difficult to determine. It depends on the state of physiological and psychological health of each individual person. But with a long history of drinking alcohol, the chances of developing alcohol psychosis increases. Usually this is several years.

The state of alcopsychosis is characterized by depression of the central nervous system and deterioration of brain functions. Intellectual abilities decrease after alcopsychosis. Even after a successful exit from it and adaptation, an alcohol addict may remain disabled, who will need the support of outsiders to perform standard actions (depending on which group he is assigned to).

Alcoholic psychoses - a short and incomplete guide

We have already begun to discuss the problems of alcoholism, the social portraits of its carriers, its dangers and treatment. Now let's take a short excursion into the most famous alcoholic psychoses. Alcoholic psychosis is a disruption of the normal functioning of the psyche, brain and body that occurs during the third and second stages of alcoholism. If we talk about the first stage, then it is very rare to find real alcoholic psychoses. As a rule, everything happens later.

It is very important to know something about the forms of alcoholic psychosis, and at least approximately their nature, in order to be able to identify them and help loved ones and other people. To identify crime arising from alcoholic psychosis. Correctly respond to manifestations of alcoholic psychosis. Maintain independence when meeting aggressive patients.

If any related situations arise in your life, contact the ANO “Forensic Expert” for legal, professional information, legal and expert support. In particular, we actively protect the rights of citizens in many situations. We also take part in many investigations of all kinds, helping our clients.

So - let's return to our chosen topic. First, let us note the main psychoses of this kind:

• delirium tremens, or delirium tremens;
• alcoholic depression;
• alcoholic pseudoparalysis;
• alcoholic encephalopathy;
• hemorrhagic polyencephalitis;
• hallucinosis;
• dipsomania;
• Antabuse psychosis;
• various alcoholic delusional psychoses.

The materials for work and for the development of alcoholic psychoses are the products of impaired metabolism and the breakdown products of alcohol in the body. It is not the alcohol itself that serves as fuel for them. To make it clearer, we can say that conditions such as delirium and hallucinosis and other psychoses are felt by patients not during alcohol poisoning, but during a decrease in its quantity and the onset of the consequences of its use.

We can also say that alcohol-related psychoses are the prerogative of not just drinkers, but alcoholics. To do this, you need to use it quite often and a lot. Also, such psychoses can occur with a combination of constant alcohol abuse and stress, acute infections, diseases of the nervous system and other factors.

Alcohol-related psychoses appear to us in different forms of development - in the order of subacute, acute and chronic. Among patients with alcoholism, of all existing alcoholic psychoses, 27% are chronic and subacute, and 45% are acute. With an experience of constant alcohol consumption of 5-7 years, the percentage of occurrence of psychosis and mental disorders reaches approximately 13. Psychoses are accompanied by incorrect reflections of reality in the mind, disorders from the field of psychoorganic, physiological, and neurological. When psychoses are repeated, they become more complex with the same pattern of construction and development.

Alcoholic hallucinosis

In the list of various alcoholic psychoses, this is the second most common, after delirium tremens, that is, delirium. We will talk about this in more detail separately. Like delirium, it is the result of many years of drinking practice, and most often occurs in women.

A patient with hallucinosis normally, unlike delirium tremens, orients himself in time and space and is in sober memory. Hallucinations are neither tactile nor visual, but most often auditory. At the same time, the patient realizes and remembers everything after this state. For this form of psychosis there are chronic, subacute and acute forms. First, the subacute form develops, then the acute form and after that the chronic form.

For several months, the patient may be bothered by the subacute form of this psychosis, during which he sometimes experiences exacerbations - transitions to the acute form. The main feeling in this state is anxiety associated with self-accusation and the presence of auditory hallucinations in the form of voices that accompany and discuss the patient. Because of this, he develops inactivity and a tendency to stay in bed for a long time. Suicidal tendencies may develop, and patients with this condition often require supervision.

Alcoholic hallucinosis in acute form, as a rule, is indicated during a hangover or abstinence, thereby acquiring the character of psychopathology. Its symptoms vary from the patient’s experiences themselves to the reactions of his psyche, body and his actions in this regard:

• basic hallucinations in the form of sounds - voices and conversations of different timbres, calls;
• sometimes – hallucinations of a tactile and visual nature;
• emotionally depressed state of mind - fear, gloominess, depression, gloomy mood;
• attempts to avoid contact with illusions, to run away or hide from voices pursuing the patient;
• so-called “persecution mania”, fear of murder, persecution, bullying;
• the patient may begin to arm himself with some means of self-defense from an imaginary threat;
• in a state of fear of aggression from someone around him, the patient may attack them.

This acute form of this disease, with complex hallucinations, can last for several days or for several months.

After suffering subacute and acute forms of this psychosis, the patient may linger or remain for a long time with “chronic” alcoholic hallucinosis. After auditory hallucinations and ideas of persecution, auditory illusions remain in the form of various voices that can discuss the patient and conduct arguments and discussions with each other. This can go on for a long time. The patient can get used to this, sometimes entering into conversations with these voices, remaining in a gloomy mood, in particular from the lack of a sense of freedom.

Treatment of alcoholic psychosis is possible with constant therapy and complete abstinence from alcohol. Treatment becomes more difficult, as experts have reported so far, if psychosis of this kind has lasted for several years.

Alcoholic paranoid

A very interesting so-called “systematic delusion”, in which the patient’s surroundings, events, and reality are assessed inadequately. Namely, this is his vision of poisoning, forgery, persecution, betrayal and other problems around him. Alcoholic paranoid also has acute and chronic stages. First of all, it arises as a primary delusion, inadequate perception without hallucinations and, as a rule, remains so. Only sometimes this psychosis is associated with hallucinations. Most often, patients in their view of reality create pictures of betrayal, harbor jealousy, and their other painful ideas, such as persecution, crimes, conflicts, and so on, are mixed into this problem. Which in general forms this paranoid syndrome, its picture.

There is also a whole range of outwardly expressed physiological and mental symptoms. Physical – sleep disturbances, intolerance to heat, dizziness, nightmares, changes in blood pressure. Mentally – normal control of emotions is lost, inhibition or lack of restraint or anger appears. Self-control in the field of moral and ethical standards of behavior is significantly reduced.

Delusional psychosis

Another of the delusional alcoholic psychoses, which appears when the body is subjected to severe intoxication, and at the same time tense, unusual, difficult situations happen to the person. The main features of this psychosis are persecution mania and jealousy. Occurs against the background of injuries, road trips, visiting unfamiliar places, and severe fatigue.

It seems to patients that those around them or some persons are creating a conspiracy, they are going to attack them, their loved ones or their family and kill them or torture them, poison them. Patients are afraid of poisoning and do not want to take medicine, sometimes attacking those they suspect of conspiracy and persecution. In this state, normal perception of reality can be almost completely abandoned.

And here, in ten percent of cases, delusions of jealousy manifest themselves - the so-called widespread psychosis. Unfounded reproaches from the wife (spouse) begin, relationships cool, and quarrels arise. The patient also blames his spouse for his sexual disorders caused by alcohol abuse. And as often happens with jealousy, it is impossible to dissuade patients from these ideas.

Alcoholic pseudoparalysis

A very common psychosis, in which adequate self-perception is disrupted, delusions of grandeur begin, and then, when the stage changes, apathy and some neurological symptoms of weakening of the body appear.

Often occurs in those who drink a lot of alcohol surrogates - liquids not intended for consumption as drinks. For example, alcohol from the so-called “point” for its illegal sale. An additional basis for the manifestation of alcoholic pseudoparalysis are vitamin deficiency, metabolic disorders and poor nutrition.

At first, such an alcoholic experiences a state of euphoria, complacency, and is not bothered by any of his own miscalculations and mistakes. He overestimates his personality, and against the background of this intellectual degradation, delusions of grandeur develop. There, various hallucinations and delusional experiences can become more active.

Subsequently, all this weakens and is replaced by an apathetic mood and state, indifference to the world and lethargy. Neurological symptoms appear, tremors or trembling of the fingers, tendon reflexes are disrupted, the pupils react poorly to light, the limbs hurt, and the patient’s speech begins to become dysarthric.

Alcoholic encephalopathy

Constant and long-term consumption of surrogates, wine and vodka - mostly - ends in such a state with neurological and somatic disorders. Such chronic and binge alcoholics suffer from hypovitaminosis, especially vitamin B, and metabolic disorders. Violation of the balance of nicotinic acid and pyridoxine. Brain and liver function deteriorate due to a lack of thymine.

Hemorrhagic polyencephalitis

The so-called Wernicke's disease - this psychosis is the main one among acute alcoholic psychoses. With it, degenerative-destructive processes develop in the body and psyche, and mental, neurological and somatic disorders appear.

Among the mental symptoms of this disease, the most prominent are mussing or professional delirium with severe agitation, which can lead to stupor. In this psychosis, natural reflexes such as sneezing, palatal, respiratory, and pharyngeal “fall out” or are disrupted, in other words. Dysarthria, tremor, oculomotor type disorders, and sleep disturbances occur.

This psychosis is dangerous because it can end in death, the likelihood of which is high. Hypotonia of the extremities, muscle twitching, loose stools, enlarged and painful liver, increased breathing, and decreased blood pressure are observed.

Alcohol depression

Alcoholic depression can last from several days to several weeks and is expressed in irritability, melancholy, feelings of inferiority, guilt towards loved ones, and accusing others and loved ones of insensitivity. In the medical literature, this psychosis is called quite rarely occurring on its own.

In this case, the patient’s mood fluctuates daily, it is reported that persistent suicidal thoughts are characteristic, and supervision of the patient is necessary. When mood swings, tearfulness, anxiety, and dysphoria appear.

Dipsomania

An interesting disease, expressed in the appearance of a sharp desire for long-term binge drinking. The basis for the appearance of dipsomania is manic depression, epilepsy, and endocrine psychosyndrome. The resulting binge drinking can occur after a long period of abstinence from alcohol, and can last up to two or three weeks. With dipsomania, the binge may suddenly end, and an aversion to drinking may appear. Dipsomania can manifest itself sharply after depletion of health and strength, for example, after sleep disturbance.

Antabuse psychosis

This psychosis is a severe form of complication when treating alcoholics with the drug Antabuse, which is also called Teturam or Disulfiram. Antabuse psychosis may appear with this treatment either due to excess doses or due to increased sensitivity to it. Which may arise due to:

• traumatic brain injury;
• organic inferiority of the central nervous system;
• chronic alcohol intoxication.

We consider the last case as the basis for antabuse psychosis, although the other two conditions can also form against the background of alcoholism and this lifestyle. Antabuse psychosis, which is and is considered severe, can occur in three stages:

• Prodromal, the first stage of psychosis, occurs from two to three days to several weeks. During the first stage, the patient is in a depressed mood, discomfort is felt in the heart area, sleep disturbance, lethargy, drowsiness, and dizziness are observed.
• The acute, second stage of the development of psychosis is either a confused consciousness, or a manic state, or mental disorders of the paranoid and hallucinatory-paranoid type.
• After this, the third stage begins - the final one. It is dominated by emotional lability, lethargy, and weakness. The state and events of the acute period of the disease are not clearly remembered.

In general, antabuse psychosis can last up to two months, or it can last only a few days. During it, there is a high probability of suicidal actions based on the perception of life situations, personality traits, and affective fluctuations caused by alcohol addiction.

Suicides, psychoses, conflicts, the possibilities of our expertise

With good family relationships, those around them, of course, treat the patient as a person and try to protect him from suicide and other severe or even irreversible consequences of alcoholic psychosis. Well, and from alcoholism, of course. But for this you need to have enough knowledge in the nature of alcoholism, the nature of psychoses, and the nature of their connection with the character of the individual and various influencing factors.

So, in particular, you need to understand that suicidal behavior is more a consequence of personality degradation, effects on the psyche, and not a consequence of underdevelopment or dementia, lack of education or knowledge. Many problems occur due to conflicts in the family, where different people, not just the patient himself, are affected by psychosis.

You can get more detailed advice on various cases from the Autonomous Non-Profit Organization “Forensic Expert”. We employ specialists in judicial and extrajudicial medical, psychiatric and psychological examinations, and your loved ones will be helped as much as possible.

To consider all specific situations, to help patients and to protect their rights, health and safety, we provide consultations and special expert research. As well as legal, expert and legal support. We can help find out and prove the commission of actions in a state of affective outbursts, if this was really the case. We will check the condition of patients and any persons at the time of performing any actions. We will use expert methods that allow us to reconstruct the picture of people’s mental and clinical states at different moments and when performing different actions. We will also conduct analyzes of alcohol-containing liquids and any liquids and substances.

Types of alcoholic psychosis

There are several categories of violations here.

Alcohol psychosis. Its types:

Hallucinations appear

• delirium;
• hallucinosis;
• delusional paranoia;
• encephalopathic conditions;
• transient.

The first point is the most common among alcoholics. Despite some preservation of the mental component, movement control is reduced to the maximum here. Hallucinations are present, the person is delirious.

An alcohol addict hallucinates in most situations, but the predominance of this symptom indicates a specific hallucinosis. These are hallucinations at the level of verbal expression and feelings, as well as affective anxiety disorders.

Delusional formation (third point) provokes the appearance of paranoia in an acute or protracted format (the second always comes after the end of the first). Here, delusions of jealousy may arise in relation to loved ones, when a person unreasonably concludes that they are moving away.

Encephalopathic disorders within the framework of alcopsychosis are expressed in a combination of somatic problems with psychological ones. Conditions are acute (E. Gaie-Wernicke) and chronic (Korsakoff psychosis, pseudoparalysis).

The last point is a twilight state that distorts the perception of space with affective pathologies (excessive fear, anger, anxiety, etc.). Hyperactivity is also present here. Such a person is dangerous. There are two forms: epileptoid and paranoid. In the first, total disorientation and loss of contact with reality appears. In the second, hallucinatory and delusional states predominate.

Symptoms of alcohol poisoning

The main signs of alcohol poisoning are common to most people. Disturbances in the functioning of the central nervous system have similar manifestations regardless of gender, age and social status.

The main critical factors in the degree of intoxication and the intensity of symptoms are the quantity and quality of the drink. Standard manifestations of intoxication are as follows:

• euphoria and delirium;
• hallucinations, visual disturbances;
• decrease in body temperature;
• impaired coordination of limbs, perception of body position in space;
• lowering the threshold of the self-preservation instinct;
• incoherent speech, slower thought processes;
• diarrhea;
• low blood pressure;
• dizziness;
• tremor of hands and feet;
• chills;
• paleness of the skin of the body, against the background of redness of the face;
• general malaise;
• frequent urge to urinate;
• pain in the right hypochondrium;
• nausea, vomiting.

Vodka

Vodka intoxication manifests itself in the same way in all patients, with variations depending on the individual characteristics of the body. Often manifested by aching, nagging pain in the abdomen, diarrhea, vomiting, delirium tremens with a sudden stop in the intake of alcohol, dizziness.

In critical cases, vodka poisoning of the body leads to an alcoholic coma, which requires immediate hospitalization.

Ethyl alcohol

If we talk about alcoholic products that are classified as food products, the symptoms of poisoning were described above. Further, it all depends on the person and the type of alcohol.

For example, the liver of an average adult man will completely neutralize 0.5 liters of beer in about 1 hour. Exceeding this dose leads to the toxic effects of alcohol.

Ethanol poisoning manifests itself solely depending on the body’s tolerance, which depends on age, gender, body weight, and nationality.

Surrogate alcohol

Substitutes for alcoholic products include not only moonshine and low-quality drinks, but also technical liquids that contain ethyl, butyl, methyl and other alcohols.

Poisoning with alcohol surrogates is dangerous because chemical combinations that are not natural for food products enter the body (fusel oils from moonshine products can be called the “safest” ones).

Poisoning with such liquids brings increased symptoms: vomiting, headache, diarrhea, tinnitus. Added to this are total chemical damage to the kidneys, liver, heart, and brain.

In the case of methyl alcohol, the result of poisoning is often complete or partial blindness due to the nature of the effect. It is important to remember that attempting to consume alcohol substitutes increases the chances of death (even after a small dose) tenfold.

Isopropyl alcohol

Isopropanol is a moderately toxic liquid and is widely used in household or technical products. The most famous solution containing it is the popular “Anti-Freeze”.

Due to the characteristic alcoholic smell, some people use it instead of alcohol. Isopropyl alcohol poisoning is similar to ordinary alcohol, but has characteristic features: a pronounced smell of acetone in the breath, continuous vomiting (sometimes containing blood).

The effect of alcohol intoxication on the body is associated with manifestations of autonomic, mental and neurological disorders. In this case, the patient’s nervous system no longer functions normally.

Alcohol poisoning, associated with a danger to people's health and their lives, is alcohol intoxication. The consequences of poisoning are determined by an increase in the level of alcohol in the blood, which can only be tested in a medical facility.

Treatment with folk remedies may be contraindicated.

There are 3 degrees of alcohol intoxication:

1. Easy.
2. Average.
3. Heavy.

At the stage of mild alcoholic intoxication, the composition of alcohol in the blood is at a level not exceeding 2%. Level 2 - 3% of alcohol in the blood is associated with an average degree of intoxication, in which a person sways when walking, he sees double, his speech is slurred, his gait is uneven, and he does not adequately evaluate the meaning of his actions and words.

Category: Narcology 25284

Alcohol intoxication is a complex of behavioral disorders, physiological and psychological reactions that usually begin to progress after drinking alcohol in large doses.

The main reason is the negative impact of ethanol and its breakdown products on organs and systems, which cannot leave the body for a long time.

This pathological condition is manifested by impaired coordination of movements, euphoria, impaired orientation in space, and loss of attentiveness. In severe cases, intoxication can lead to coma.

A hangover syndrome is nothing more than alcohol poisoning, caused either by a single case of drinking alcohol or as a consequence of binge drinking of varying duration. The syndrome manifests itself as follows:

• nausea accompanied by headache, frequent vomiting;
• unstable state: a sharp transition from depression to pronounced aggression;
• bags under the eyes, general swelling of the face, puffiness;
• dry mouth;
• lack of appetite;
• increased sweating;
• general malaise, tremor;
• circulatory disorders: redness of the eyes, distinct pallor of the facial skin;
• poor tolerance to bright light and loud sound;
• non-standard perception of what is happening at the time of the hangover.

When ethyl alcohol enters the body, its toxic effects cause a chain of metabolic transformations. This feature can affect nerve cells and tissues of different organs in different ways.

If we add to the listed factors, and take into account how much alcohol was drunk, what quality, strength and condition of the organs (kidneys and liver) involved in processing the alcoholic product, the syndrome may drag on for several days.

In people who drink a moderate dose of alcoholic beverages, the frequency of drinking alcohol is purely conditional, or rather, from time to time, the hangover syndrome does not manifest itself in severe and moderate forms; if this happens, then the unpleasant condition goes away during normal sleep or proper rest.

How to define delirium tremens? There are symptoms that help recognize the disease. The attacks appear a few days after the addict stops the binge.

At first, a person experiences strange sensations - an aversion to alcohol appears, drinking is no longer attractive. The drinker stops drinking alcohol. Relatives and friends should be on the alert; there is no need to think that the person just gave up the addiction.

When evening comes, the patient experiences a dramatic change in mood: a positive attitude is replaced by aggression or a depressed state. A person suffering from alcoholism often experiences unreasonable fear and is in apathy.

Some patients show incontinence and cannot control their movements, cannot sit still, and constantly chatter. Symptoms of delirium tremens also include trembling in the arms and legs. As for sleep, it is very restless; patients with delirium tremens often have nightmares both in sleep and in reality.

Delirium

Kinds:

• classical;
• heavy;
• reduced;
• atypical mixed;
• with oneiric disorders.

Delirium

The first is a consequence of giving up alcohol (when after a couple of days “withdrawal” or withdrawal syndrome appears). The addition of a poor physical condition and physical trauma to the “withdrawal”, as well as the presence of other toxins in the blood, provokes the appearance of alcopsychosis. Its flow makes it heavier. Its duration can be up to 10 days.

The severe form usually appears with equally severe illnesses that debilitate the body (for example, pneumonia). Such persons are poorly oriented in space and time. This form becomes the cause of brain dysfunction (such as encephalopathy). It is almost impossible to get out of this state safely.

The third point provides for the occurrence of short-term psychotic disorders. They appear briefly and disappear while other symptoms of advanced alcoholism persist. A person orients himself better in space than in time. Hallucinations are present.

The mixed subtype is not typical in that it combines features of not only alcoholic, but also other psychoses. The last form of delirium with oneiric disorders has not just hallucinations and confusion, but also a dreamlike stupor (the involuntary appearance of fantasy images), as well as stupor.

Psychosis due to alcoholism: manifestations and consequences

People who have suffered from alcoholism for many years develop a disease called alcoholic psychosis after a long binge.

Previously, this condition was not considered a disease, but after lengthy research it was found that the disease has several types and has a negative effect on the central nervous system.

Psychosis requires diagnosis and immediate treatment, because in some cases, lack of medical intervention can lead to death.

What is alcohol psychosis and why does it occur?

With prolonged use of alcohol-containing alcohol, general intoxication of the body develops, the functions of the brain and central nervous system are disrupted.

People who drink alcohol for 5 years or more have metabolic disorders.

Against the background of such changes, alcoholic psychosis gradually develops in the body, which lasts up to 7-10 days, but it is impossible to say for sure how long it will last, how long it will last in each individual case.

Most often, the disease manifests itself after a sharp cessation of alcohol consumption after 1-5 days against the background of severe withdrawal syndrome. In some cases, with prolonged drinking bouts and consumption of low-quality drinks or surrogates, the disease occurs at the peak of binge drinking.

The causes of the disease are:

• long-term use of products containing ethanol, stages 2 and 3 of alcoholism;
• genetic predisposition;
• severe brain infections or injuries, somatic diseases;
• social environment and living conditions.

Taking into account the characteristics of the body, the degree of damage to internal organs, the psychological type of a person, the presence of stress, etc., the symptoms of the disease and its duration may vary.

Symptoms and diagnosis of alcoholic psychosis

Symptoms of the disease vary depending on the type of psychosis. But general signs of alcoholic psychosis appear a few days after stopping drinking alcohol. A person’s mental state gradually deteriorates, sleep is disturbed, tremors of the limbs, sweating, constant anxiety, and unreasonable fears appear.

A late diagnosis and lack of medical care leads to the development of the disease. Insomnia and visual illusions appear, in which a person sees insects, small animals and non-existent creatures that attack him. Delusions and hallucinations, confusion and complete loss of orientation develop.

The disease can be diagnosed only by examining the patient and collecting data. The presence of stages 2 and 3 of alcoholism and a previous binge that lasted at least 10 days differentiate psychosis resulting from alcohol consumption from other mental illnesses.

Classification of alcoholic psychosis

Psychoses due to alcohol abuse are divided into several types according to the clinical picture:

• delirium tremens;
• delusional psychoses, paranoid;
• hallucinosis;
• Korsakoff psychosis;
• alcoholic encephalopathy;
• alcoholic epilepsy.

Delirium tremens, or delirium, is the most common metal-alcohol psychosis among patients of narcologists. This disease occurs against the background of withdrawal syndrome after 1-3 days, lasting from several hours to 7 days. Accompanied by sleep disturbances including insomnia, sweating, tremors, anxieties and fears, hallucinations, disturbances in heartbeat and breathing.

A patient in this condition is capable of causing physical harm to himself, even suicide. It also poses a threat to others.

This disease occurs in various forms, from mild to atypical. In severe disease crises, death is possible.

Delusional psychoses develop in men with a long history of drinking drinks containing ethyl alcohol (more than 10 years), and almost never in women. With frequent withdrawal symptoms, insomnia, constant anxiety and fear, acute paranoid delusions develop, in which a person claims that they are watching him, they want to kill him, etc.

Acute paranoid develops quickly, over a few days. The protracted form develops very slowly and lasts for several months. The man’s behavior looks normal from the outside, but he becomes distrustful, suspects everyone and sharply limits contacts with other people.

In men 40-50 years old of the neurotic type, alcoholic paranoid manifests itself as delusions of jealousy. This condition lasts for years. The man is sure that his wife is cheating on him, is constantly late, and is hiding something from him. He begins to follow her, seeing every little thing as confirmation of his assumptions. Such patients pose a danger to their wives.

Hallucinosis occurs less frequently than delirium tremens, but ranks second among psychoses caused by ethanol consumption. Develops during binge drinking or withdrawal symptoms. It is characterized by auditory hallucinations, rarely visual.

The patient is well oriented, aware of his location, time and is aware of everything that is happening, but at the same time constantly hears voices. Screams or whispers are threatening in nature, the person becomes nervous, fearful, and tries to defend himself. This condition lasts from one month to a year, but in some cases lasts several years.

Korsakoff psychosis is a chronic disease. It occurs after a severe form of delirium tremens or encephalopathy in women who drink for a long time. The symptoms of this form of the disease are specific. The patient has amnesia and amnestic disorientation. At the same time, the woman remains critical of the state of memory and tries to hide it from others.

During Korsakoff's syndrome, neuritis of the lower and upper extremities develops, followed by muscle atrophy.

Encephalopathy manifests itself as mental and neurological disorders simultaneously. It has a chronic form, developing during the transition from the 2nd stage of alcoholism to the 3rd.

The disease is characterized by weight loss, lack of appetite, and pain in the epigastric region. The patient's condition is constantly deteriorating, various mental disorders appear, in some cases dementia and pseudoparalysis. This type of psychosis has a high mortality rate.

Alcoholic epilepsy occurs during heavy drinking or is one of the manifestations of acute delirium. Seizures are no different from epilepsy. The most severe seizures occur when alcohol consumption is abruptly stopped. Actions to stop an attack are the same as helping with epilepsy.

After completely stopping drinking alcohol, the attacks go away.

Treatment of alcoholic psychosis

Acute and chronic alcoholic psychoses require treatment in the inpatient department of a drug treatment clinic. Depending on the patient’s condition and the type of psychosis, drug treatment is selected individually. Most often required:

• infusion therapy to detoxify the body;
• the use of nootropic drugs in combination with psychotropic drugs;
• relief of hallucinations;
• enhanced vitamin therapy.

Treatment of psychosis after binge drinking at home is not recommended and can be dangerous to the life and health of the patient and others. Symptoms such as aggression, suicide attempts and self-harm may not appear immediately but will develop over the course of treatment.

Dear readers! We strongly recommend that you consult a doctor before taking medications or self-medicating. There are contraindications.

Source: https://eustress.ru/psychosis/alkogolnyj-psihoz

Causes of alcoholic psychosis

The main thing is long-term drinking of alcohol. This period can reach several years. It is a binge or chronic form of drinking. The drinks here are fortified with a high percentage of alcohol. Somatic manifestations such as alcopsychosis are not a necessary stage in alcoholism. It all depends on the individual clinical picture of the patient. That is, his general health (including psychological).

Uncontrolled drinking of strong drinks

Everyone's sensitivity is different. A predisposition is often identified when the patient has insomnia (the emphasis is placed on this), scary dreams, increased anxiety and uncertainty. He may already have a neurotic disorder, but this is not psychosis itself.

Symptoms

Alcohol psychosis. Symptoms:

Fever

• tachycardia;
• fever;
• increased sweating;
• hyperemia on the skin and in the sclera of the eye (“whites”);
• tremor (in difficult situations, loss of coordination).

In an extended blood test:

• acceleration of ESR in a general blood test;
• and an increase in bilirubin in the blood;
• leukocyte surges.

Increased leukocytes in the blood

Even when performing an advanced analysis on your own, such indicators are indicated in tabular form.

Symptom progression pattern:

Insomnia hallucinations

1. Insomnia appears or short sleep with severe nightmares.
2. Then visual illusions are added (for example, it seems that inanimate objects think, look at a person and want something from him).
3. Hallucinations intensify. It all starts with the appearance of small objects in the field of vision and gradually the person becomes a participant in entire hallucinatory scenes.

Hallucinations are complemented by delusions in reasoning and behavior. The peculiarity of alcopsychosis is that the person is not changed for himself. He does not hallucinate about changes in his body or becoming some kind of creature. Only the space surrounding him changes, into which he is drawn more and more. But in his unchanged form (his person). Orientation in the environment decreases, but orientation in one’s own body and personality is preserved. He understands who he is, but not where he is or what is happening around him. There is no critical thinking about what is happening outside of it. He takes everything for granted. Like it's real. He believes in hallucinations completely.

Alcohol delirium

This type of alcoholic psychosis is one of the leaders among the most “popular” psychoses among alcoholics. Delirium tremens is popularly known as “delirium tremens.”

Symptoms of alcoholic delirium include clouded consciousness of the patient, accompanied by numerous vivid auditory and visual hallucinations. These symptoms, in most cases, are quite amenable to observation by other people, in particular, the alcoholic’s family. The patient may be in an extremely anxious or aggressive state (sharp mood swings from apathy to excitement are common phenomena for this condition), react to things that do not exist in reality (for example, brushes off or runs away from something), and has difficulty navigating the area. Tremors of the limbs may occur.

In addition, symptoms may include a loss of craving for alcohol and even an aversion to alcoholic beverages. Alcohol delirium can occur during binge drinking. It happens that, in a fit of fear of unpleasant sensations, an alcoholic may at least temporarily decide to quit drinking, however, the consequences of delirium can also be tragic, because often patients in an attack of delirium tremens commit suicide. For various reasons, about 15% of patients die from alcoholic delirium.

The development of alcoholic delirium itself is usually accompanied by some other physical symptoms. These include chills, pale skin tone, increased sweating, yellowing of the whites of the eyes, dehydration, etc.

You should not treat delirium tremens on your own. Urgent hospitalization is required.

At this time, it is best to isolate the patient so that he cannot harm himself or others (for example, tie him to a bed). It is useless to appeal to the patient’s common sense - this is what is absent in an alcoholic in a state of delirium tremens. Drastic measures are needed. Do not be afraid to seek help, even if you are afraid of publicity, because in the case of this psychosis we are talking about the life and death of your relative.

Treatment

Treatment should begin at the first manifestations of inappropriate behavior. The risk of death in alcoholic psychosis increases. A person becomes dangerous to himself and others, and his internal organs are overloaded. If the patient's condition is inadequate, he may be forcibly restrained to limit his activities and begin intoxication therapy.

The internal organs of alcohol addicts experience increased overload

The content of the entire course of treatment depends on the degree and clinical picture of the disorders (physical and mental spectrum). And also on the specifics of the work and the schemes used in a particular medical institution.

Measures taken:

• relief of physical and mental hyperactivity: tranquilizers, glucose solution, anticonvulsants, sleeping pills;
• restoration of metabolic processes (to improve the functioning of the kidneys, liver and brain): detoxification with intravenous infusions, gastrointestinal tract lavage, use of corticoids, bile and diuretics, etc.;
• normalization of the cardiovascular system: pacemakers, in severe cases adrenaline;
• to combat hallucinations and other psychotic disorders: antipsychotics, nootropic medications, and a vitamin complex along the way;
• If a patient has problems with respiratory function, he is prescribed inhalations.

Note!

Limiting yourself to home treatment and folk remedies for alcoholic psychosis is strictly prohibited. This threatens death. You need to entrust your health or the health of a loved one to professionals.

Causes of the disease

Regardless of the type, psychosis does not appear due to alcohol consumption, but as a result of prolonged poisoning with decay products . Thus, these disorders are observed only in people with 2-3 degrees of alcoholism.

It’s just that during constant drinking, the kidneys, liver and other organs that are involved in removing waste products slowly begin to cope with this, which significantly slows down the elimination of toxic substances and reduces their function.

Subsequently, the breakdown products begin to linger in the body for a longer time, and an adaptation process occurs.

Alcoholic psychosis is the result of regular alcohol abuse, but most often there are additional factors, such as infectious diseases, severe stress or injury due to a fall. Psychosis can appear only in people who suffer from alcoholism after or during prolonged drinking.

The mechanism of psychosis is quite complex. It is believed that psychosis occurs during abstinence. That is, at first a person is in a long-term binge, while a large amount of toxins accumulates in the body, but during a sharp refusal of alcohol and the onset of withdrawal symptoms, the appearance of alcoholic delirium or other types of psychosis occurs.

In this case, the problem is the body getting used to the processes that occur in the organs when drinking alcohol and the decay products. A sharp decrease in alcohol leads to delirium tremens. The relationship between stopping drinking after a long binge is quite clear. It’s just that for people who rarely drink alcohol, taking a significant dose of alcohol can only lead to poisoning, but not to the onset of psychosis.

Consequences

These affect the cognitive sphere, the central nervous system, and affect the ability to perform standard social roles. There is a degradation of personality and the person is simply no longer able to take responsibility for himself, work normally, etc. Because of alcohol addiction, they do not give disability, but if alcoholism has caused serious changes in personality and somatic well-being, then the alcoholic becomes disabled. This threatens with corresponding restrictions in work.

Changes in consciousness occur

After drinking alcohol for a long time and the occurrence of psychosis against this background, disturbances in the functioning of all internal organs are observed. The psyche is disturbed. The person experiences an excessive feeling of anger, resentment, anxiety (even neuroses).

Such a person loses his social connections. Relatives and friends turn away from him, he loses his job. It is very difficult to improve your life after this and return it to its previous course. The support of relatives is of fundamental importance here. Maintaining contact with relatives is also important in a situation where a former alcoholic loses the ability to care for himself.

How an alcoholic's will disappears

Mood fluctuations deprive alcoholics of constancy in their actions, which, according to Vlassak, leads to the lack of will characteristic of this disease , which, of course, is difficult to disagree with.

It is rarely possible to correctly predict what an alcoholic’s behavior will be in a given situation. Everything will be determined by the mood of the moment. None of the previous principles matter to them anymore .

If at this moment the alcoholic is offended, then he will not hesitate to hit a loved one in the face, for example. Or, if he really wanted to drink, he would steal the last money from the pensioner’s mother. That is, their will is turned off . They are in no way able to endure resentment or desire for something.

Gradually, emotional hardening of alcoholics sets in. The circle of people who evoked feelings of sympathy, affection, and care is narrowing. Warm feelings gradually disappear, replaced by indifference , easily replaced by negative emotions that arise without sufficient reason. An alcoholic can no longer love as deeply as before. And behave in such a way as to preserve this feeling for the other half.

The former wide range of differentiated relations is disappearing. With the increased amplitude of emotional fluctuations, the variety of emotions is replaced by rough and mostly two-color affects. For an alcoholic there are no halftones , in a word. No options. He reacts with either hysteria or aggression.

The polarity of affect is also disproportionate: usually one of two affects dominates. Most often this is an angry cry , over the most insignificant reason.

The inconstancy of emotional reactions, which is at first a disease (at first, almost all alcoholics are whiny and asthenic), subsequently acquires a dangerous character , both for the alcoholic himself and for those around him. He exploded and that’s it, an immediate reaction, the will to restrain himself - an alcoholic has no...

How long do people live with alcoholic psychosis and after?

It’s difficult to answer unequivocally here. It all depends on the specifics of the patient’s condition, his desire to recover, and on the surrounding background (presence of support). If you continue to be actively dependent on alcohol, your life expectancy is reduced quite significantly. A person may not survive the onset of alcoholic psychosis due to organ failure or the occurrence of accidents in an altered mental state. Suicides are rare here.

You can't survive psychosis

When recovering from withdrawal syndrome and possible alcohol psychosis, life expectancy will depend on the subsequent lifestyle and the resulting health problems. You can return to your previous lifestyle (as before alcohol addiction) and live until old age, being considered conditionally dependent forever.

Chronic and acute alcoholic psychosis

The form of the disease can be chronic or acute. Acute alcoholic psychosis is characterized by a change in all of the above subtypes (depression, epilepsy, delusional psychosis). In the chronic form of the disease, as a rule, one disorder is observed (delusional psychosis, for example). Therefore, chronic psychoses are less dangerous. But, if you do not treat them, the disease can worsen at any time.

If in the chronic form of the disease a person behaves relatively calmly, then in the acute form of alcoholic psychosis the person becomes aggressive, suspects his entire surroundings, and starts fights.

Regardless of the form of the disease, treatment is best done in a hospital.

Is there a difference between female and male psychosis

The phasing that is observed in alcoholism of both sexes is the same. That is, addiction here has identical stages in its development. In both cases, alcohol also has the same negative effect on the functioning of internal organs and the central nervous system. The difference in the process of passing through alcoholic psychosis is of course revealed. Both sexes equally experience delusions, hallucinations, anxiety, and everything else. But by nature, men are physically stronger, so the chances of aggression here increase. Women are more unstable psychologically, so it is difficult to pull them out of this depressed psychological state.

The principles of treatment with medication are approximately the same. They depend on the prevalence of certain symptoms. It should be taken into account that the same psychotropic drugs can depress the psyche even more. Therefore, with women, sometimes you have to pay a little more attention to the therapeutic course for mental disorders.

Female psychosis

Chronic bad mood of alcoholics and suicide

An example of instability of the emotional background can be dysphoria (depression) of alcoholics. It is no coincidence that some authors consider alcoholism as a fatal disease , due to not only ordinary accidents, but also no less frequent suicides.

In the group of alcoholics, suicide rates are approximately three times higher than in the general population of the same age and gender. Only failed suicide attempts were noted in 45% of 1250 alcoholics.

Self-hanging is a typical method of suicide for alcoholics. It is impossible to agree with those authors who see the suicide of an alcoholic as a consequence of awareness of his guilt. This is absolutely not true .

Firstly, because suicides are more often observed in the initial (last) stage of the disease, when criticism of one’s condition is reduced to the limit.

Secondly, suicides are timed to coincide with withdrawal syndrome, characterized by affect and a feeling of wild melancholy and anxiety.

The subjective motivation for these failed suicide attempts only speaks of rationalization. You need to somehow explain your actions to people. But no logic in such a feeling of guilt .

For example, what kind of guilt are we talking about if an alcoholic tries to hang himself, leaving his wife with a baby in her arms and without a livelihood? Or, an alcoholic hangs himself because he can’t pay the mortgage and he doesn’t care that all the payments will fall on the family... Is it his fault?

If we see in suicide recognition and consciousness of guilt, then suicides should, in theory , be more frequent in the second stage, and without connection with withdrawal syndrome. At the second stage they are much more tormented by their conscience than at the third. By the third, they are already emotionally stupefied .

Strelchuk’s point of view cannot be ignored. He believes that suicide is one of the manifestations of the extinction of social and biological dominants in alcoholics: labor, self-preservation, etc.

Also, one cannot help but recall the fact that there are much fewer suicide attempts at the second stage than cases of severe beating of relatives and the use of violence. And this is the stage when feelings are still practically intact, unlike the third.

Narcologist's comment

Alcoholic psychosis, even in its most complex form, implies coercion in treating such a person (without his consent). Registration with state medical authorities is fraught with negative consequences in the future. For example, restrictions on legal capacity (up to restrictions on independent disposal of one’s own property). But the consequences of refusing to see a doctor are even more depressing. The most negative outcome is the death of a failed patient. Therefore, it is necessary to treat loved ones in a timely manner. Or contact a medical facility yourself if this fate befell you personally.